Anonymous wrote:

Anonymous wrote:As I understand it, DBT is a subset of cognitive behavioral therapy, could you start with a therapist who uses CBT with DBT as an option if needed?

CBT is good for more typical anxiety and depression. Kids with thoughts of self harm tend to be more emotional unstable, and are less able to identify their negative thoughts and feelings. DBT adds mindfulness techniques to help them identify and accept negative feelings.

Well said. Also, you pay more because the therapist really needs to be on call at all hours when not in session at the beginning of treatment. A CBT therapist might discourage late calls to teach boundaries, but a DBT therapist has to be willing to take those off hour calls while the client is learning to apply the skills. Often someone who needs DBT is going to need more emotional support to learn to apply the skills than your typical CBT client who can have a difficult time, apply the skills and wait until the session to discuss what worked and what didn't.

Anonymous wrote:As I understand it, DBT is a subset of cognitive behavioral therapy, could you start with a therapist who uses CBT with DBT as an option if needed?

CBT is good for more typical anxiety and depression. Kids with thoughts of self harm tend to be more emotional unstable, and are less able to identify their negative thoughts and feelings. DBT adds mindfulness techniques to help them identify and accept negative feelings.

^^take your child home, not take your hold home.

Anonymous wrote:As I understand it, DBT is a subset of cognitive behavioral therapy, could you start with a therapist who uses CBT with DBT as an option if needed?

If 2 clinicians recommend DBT, then you need to do DBT. Many CBT therapists are not fully trained for DBT and they must be to do it properly.

My son, for other issues, did the PHP program at Shepherd Pratt in Towson. They use DBT and it’s 7hrs per day. My son was in the program for 2 weeks but some were there shorter and some longer.

The in take process was pretty simple. Go there and meet with an intake psych. You would mention the self harm and the school psych and ped recommendations. That should get you in. You do not have to accept a placement if you don’t like it, ie if they offer you in patient, you can say No and take your hold home. Fair warning—if you are offered placement, you start the following morning.

Given the time of year, you might be able to time the program with winter break. SP is in network with a lot of insurance companies.

When my son came out, he worked with his local psychologist using a mixture of DBT and CBT. He did see his therapist 2x/week when he first came out of the PHP. As PPs have said, DBT is intensive and this program really jump started my son. SP will help find you an appropriate therapist as part of the discharge plan if you don’t have one.

It is essential the person have the proper training and be skilled and when a youngster is at risk for suicide it will and should cost more. (Thoughts of self harm makes the child at risk for attempting suicide). They need to be on call more and the therapy needs to be more intensive. Plus, they are taking on a huge amount of potential liability. People will and do sue if their loved one actually commits suicide. Even the most skilled therapist cannot stop someone who does not want to be helped. I understand your son is not at this point, but the thoughts of self harm part is serious and needs a high level of care.

I looked into it a few months ago. If my memory is correct, I found the costs to be in the $3k per month range. I don't recall testing costs.

I have read, but no personal experience, that you may have success appealing for in network benefits through your insurance company for DBT if they can’t find you an in network provider (which typically, at least in this area, is not available). See here: http://www.dbtmetro.com/insurance/
(Also, that website is a consortium of DBT providers.)

We went to Instep in Fairfax.
We did parallel sessions. Our child went to group therapy. Parents had our own session.
I think it was a good format to have both sessions happening at the same time so we could all learn together.
It was about $200 per week.

As I understand it, DBT is a subset of cognitive behavioral therapy, could you start with a therapist who uses CBT with DBT as an option if needed?

I have some experience with DBT for a young adult. As PP said it is intensive. It is also difficult and can take a year to see results, but was ultimately very effective in our case.

$350 per session is high, but good DBT therapists are hard to find. I can't imagine what kind of assessment would cost $7,000.

Anonymous wrote:DBT is expensive as it is intensive therapy. But that seems high. No experience with DBT for a child, but DH pays about $1500/month for twice a week therapy. The initial evaluation was a few hundred. I'd call a few places - you can find DBT-trained therapists at https://behavioraltech.org/resources/find-a-therapist/.

This is so helpful. thank you

DBT is expensive as it is intensive therapy. But that seems high. No experience with DBT for a child, but DH pays about $1500/month for twice a week therapy. The initial evaluation was a few hundred. I'd call a few places - you can find DBT-trained therapists at https://behavioraltech.org/resources/find-a-therapist/.

My son (10) has been having thoughts of self-harm. He told this to the school psychologist and gave details about his thoughts. She and a team of others evaluated him at my request because he has been having anxiety and emotional trouble. The school has been wonderful and they are working on a plan for him. The school psychologist recommended he see someone who can do Dialectical Behavior Therapy. She also recommended I immediately contact the pediatrician and share the report which I did. The pediatrician (on her own accord) also recommended DBT. She gave me the name of someone local who is supposedly very good. I have been in touch with the assistant of this recommended psychologist and she sent me the paperwork, contract and fees. It's really expensive. It says the testing will cost 7K and each visit is $350 per 45 min. It says more than one visit per week may be necessary in the beginning. This sounds insanely expensive to me. Does anyone have experience with this? My son has already had a neuropsych evaluation (it is now 2.5 years old) and he recently had a psycho-educational evaluation through the school. 7K for additional testing sounds crazy to me. This is obviously a serious issue and my son needs professional help. I would certainly pay the money if this is what it takes to help him, but I'm hoping I can find some good help that is not this expensive.

Thank you for your advice.